JUNE 2025 Recalls Compilation
37 lady bartender, husband says she ignores him. Weber lateralises R, Rinne AC>BC both ears. Concern re hearing. Diagnosis?
a/ L sided SNHL from loud music
b/ Earwax blocking L ear canal
55 lady on MTX for RA, fever, dry cough, SOB, pleuritic CP. Bibasal crackles, diffuse infiltrates on CXR. On ramipril. Cause?
a/ Drug induced pneumonitis
b/ Bacterial pneumonia
70 guy with prostate CA already mets, LBP on morphine slow release. Needs extra morphine for breakthrough pain. Breakthrough dose?
a/ 1/12 to 1/6 total daily dose PRN
b/ 1/10 to 1/5 total daily dose PRN
67yo man w/ CHF, SOB, leg oedema, fine creps. Discussed meds and lifestyle. Advice re fluids + salt? Next step?
a/ Brian to restrict Na <2g/day & fluids <1.5L/day
b/ No specific Na or fluid restriction in HF guidelines
38 woman RN, neutropenia found on routine bloods, asymptomatic. Repeat tests same after 6 wks. All other Ix normal. Advice?
a/ Repeat CBC in few months to check abnormality
b/ Refer to haematologist for bone marrow bx
75 guy w worsening central vision, straight lines appear bent. Brown lesion seen at macula. Peripheral vision okay. Diagnosis?
a/ Macular degeneration
b/ Amaurosis fugax
36 male with 4-mo LBP, stiff in AM, better w/ activity. Alternates buttock + lower spine pain. No trauma. Associated condition?
a/ Apical Pulmonary Fibrosis
b/ Coeliac Disease
Psych pt on meds, flagged ECG shows QTc 500ms. Seen in rural ED, rate 61 bpm. Most likely drug cause?
a/ Haloperidol
b/ Aripiprazole
51guy, brother died of CRC at 65. No sx, PR bleeding once w/ constipation last yr. No red flags on exam. Next step?
a/ FOBT now, then every 2 yrs if no low dose aspirin
b/ Colonoscopy now, then every 5 yrs
4yo boy w/ loud snoring, recurrent tonsillitis (4x/yr, 2 yrs). Recent ear infection. Mum concerned. Referral indication?
a/ Upper airway obstruction in kids w/ OSA
b/ 3 tonsillitis episodes in 1 yr
40 lady with 3-mo itchy L ear, no pain. TM abnormal on exam. No fever or resp signs. Likely organism?
a/ Aspergillus niger
b/ Candida albicans
38 man with RA, 3-mo R groin pain, worse, no trauma. Antalgic gait, ↓IR, +Trendelenburg. X-ray normal. Next test?
a/ Magnetic Resonance Imaging
b/ Ultrasound
25yo man w dental pain from hot/cold, no swelling. Pain stops after eating. Can’t see dentist till Mon. Other mgmt?
a/ Reassure no analgesia/ABx needed now
b/ Regular oral paracetamol + codeine
35 lady w 6-wk swollen painful MCPs, worse in AM, better w/ use. Suspect RA. Best specific test?
a/ Anti-CCP
b/ Anti-dsDNA
55male with gout flare in R big toe. On multiple meds, Hx of TIA + HTN. Med contributing to ↑urate?
a/ Aspirin
b/ Ramipril
c/ Atorvastatin
71 yo old man with T2DM, early retinopathy noted. On irbesartan, statin, Janumet. Which med slows retinopathy?
a/ Fenofibrate
b/ Aspirin
c/ Perindopril
35man with 3-wk anal pain post BMs, blood on wiping, firm stool every 2-3d. No red flags. Diagnosis?
a/ Anal fissure
b/ Anal skin tags
c/ Anal warts
42 lady with BMI 34, HTN, failed diet/exercise. Wants bariatric surgery. Eligibility criteria?
a/ BMI >35 or >30 w/ comorbidity not fixed by non-surg
b/ BMI >30 or >25 w/ comorbidity not fixed by non-surg
74man withacute lower abdo pain, can’t void. Hx of LUTS, smooth large prostate on DRE. Cause?
a/ Benign prostatic hyperplasia
b/ Acute bacterial prostatitis
20man with asthma, well-controlled on ICS/LABA. Rare SABA use, had prior ED visits. Advice for worsening control?
a/ Up preventer dose ASAP + inc salbutamol freq in exacerbation
b/ Inc salbutamol freq, keep preventer dose, see doc if pred needed
78 yo farmer w 3-day rhinorrhea, green sputum, pleuritic CP, mild fever, SOB, L creps. T2DM + HTN. What’s a red flag for inpatient CAP?
a/ Multi-lobar CXR involvement
b/ O2 sat <94% RA
17yo male w/ 1-wk dysuria + mucoid urethral discharge, neg gonorrhea/chlamydia tests. Sex active. Most likely dx?
a/ Mycoplasma genitalium
b/ Adenovirus
c/ Herpes simplex virus
39 lady switched from COCP to Microlut 3 wks ago, missed today’s pill, unprotected sex at 1:30am, took pill at 12:30pm. Advice?
a/ Tell her to get emergency contraception now, keep pill at 8am & use condoms till 3 daily pills done
b/ No emergency contraception needed, keep pill at 8am & use condoms till 3 daily pills done
31 guy runner w/ gradual lat knee pain over lateral femoral epicondyle, worse w/ heel strike, no trauma. Dx?
a/ Iliotibial band syndrome
b/ Quadriceps tendon tear
18 lady confused, agitated at rural festival, drunk 5-6 vodkas, unsure on drugs. ER no beds, plan transfer to regional hospital. Next step?
a/ Try to calm her by moving to quiet room & speaking calmly
b/ Give IV droperidol 10 mg
Boy with 1-day limp, afebrile, limited hip IR, better w/ paracetamol. Suspect transient synovitis. Usual age range?
a/ 3 – 10 years
b/ 6 months – 18 months
5yo girl with divorced parents, father calls for consult info, unsure custody/orders. Next step?
a/ Tell dad can’t share info without custody verification
b/ Tell dad to contact mum for info.
49man on haloperidol for bipolar, now has palpitations. ECG shows?
a/ Tachycardia w/ QT prolongation
b/ AF w/ rapid ventricular rate
45man with curved penis, painful intercourse, L side palpable plaque. Most likely dx?
a/ Peyronie’s disease
b/ Balanitis
c/ Balanitis xerotica obliterans
34male w 6-mo fatigue, polyarthritis (hands+knees), ferritin 300, transferrin sat 48%, stable. What’s correct?
a/ HH tx 1st line: regular venesection & iron monitoring
b/ Advise alcohol abstinence in HH management
63man w fatigue, gynaecomastia, low T, normal prolactin + iron. No meds or hx. Next step?
a/ Repeat his fasting testosterone and luteinising hormone levels at 0800 hours on another day.
b/ Commence him on testosterone gel 1% applied topically daily.
67 lady worried about stroke risk after husband’s ischaemic stroke from AFib. No symptoms. Advice on AF screening?
a/ Screen silent AF in pts ≥65 yrs
b/ No screening silent AF per current guidelines.
70 lady with new paroxysmal AF, DM, HTN, no stroke/falls hx. CHA2DS2-VASc stroke prevention next step?
a/ Start apibaxan 5mg orally twice daily.
b/ Start aspirin 100mg orally daily.
67 male with severe R knee OA, scheduled TKR. Surgeon says early mobilization after surgery is better than long bed rest. What to tell him?
a/ Early mobilise same day, ideally 4-8 hrs post TKR
b/ Early mobilise 24-48 hrs post TKR.
40yo lady with 12 mo fatigue, weakness, weight loss, low Na, high K, low fasting glucose. Likely cause?
a/ Addison’s disease
b/ Cushing’s syndrome
c/ Conns syndrome
57 lady smoker w/ chronic cough + worsening SOB. Spirometry done (obstructive pattern). Interpretation?
a/ Moderate obstructive airway dz, no reversibility
b/ Mild obstructive airway dz, no reversibility
45 lady post-Mycoplasma pneumonia, now w/ fatigue + SOB, anemia normocytic, high LDH, high bili. Most likely diagnosis?
a/ Autoimmune haemolytic anaemia
b/ Aplastic anaemia
12yo boy w/ persistent night cough, coughing fits, vomiting, pertussis PCR+. School exclusion duration?
a/ Exclude child until 5 days of antibiotics given
b/ Exclude child 14 days from cough onset
38 lady husband had recent infidelity, +chlamydia NAAT, started doxy, reluctant to inform wife. Next step?
a/ Help husband notify all partners last 6 months about chlamydia
b/ Refer wife care/testing to colleague.
59 male truckie w/ severe OSA on CPAP, moderate daytime sleepiness. Driving advice per Aust guidelines?
a/ Needs sleep specialist consult for conditional commercial licence
b/ Can drive private licence if compliant w/ CPAP & response good